Medicaid and CHIP are separate programs, but they are both programs that are jointly funded by the state and federal governments. Regulations for each program are put in place by the federal government, but they are run at the state level, and each state has some leeway in how they run their programs.
To apply for Medicaid, you need to apply through your state’s Medicaid office. There should be at least one Medicaid office in each county. Most states allow you to start your application process online. When you get your application, you will also get a list of documents you will need to provide to determine your eligibility. These documents may include proof of income, social security cards for each member of the household or immigration status documentation, and proof of residency.
There is a broad range of eligibility factors your state may take into account when determining eligibility. Generally those factors include residency, income, age, citizenship, immigration status, pregnancy, and household income. You will need to check with your state to see exactly what the eligibility standards are and what documentation is needed.
Check Your Eligibility
Once you submit your application, you may need to go to the office for an interview with a Medicaid caseworker. This is generally the last step in the application process.
Children’s Health Insurance Program (CHIP) is an insurance program specifically designed to provide low-cost health insurance for children if their families are not eligible for Medicaid under the income requirements. Because CHIP is also run by the states, eligibility standards vary from state-to-state. Some states allow parents and pregnant women to also be covered under CHIP.
There are three ways to apply for CHIP.
- Go to this site. Then select the state you live in, and you will be directed to the correct application page.
- Call 1-877-543-7669 and apply by phone.
- Fill out the Health Insurance Marketplace application. When you submit this application, you will be informed if you or any of the members of your household may be eligible for Medicaid or CHIP. If your children are eligible for CHIP, you will be contacted regarding your enrollment in the program.
Similarly to eligibility, CHIP benefits and coverage varies by state. However, all state CHIP programs cover:
- Doctor visits
- Routine check-ups
- Dental care
- Lab services
- Emergency room visits
- Inpatient and outpatient care
Well child and dental visits are completely free to the parents under this program. Other services may require a co-pay, and some states charge a monthly premium. However, the monthly premium will never be more than 5% of the household income.